Ivermectin ~ a World Health Organization “Essential Medicine”

I’m getting ready to take ivermectin against strongyloides and want to share my research so it may help others. It seems that ivermectin is a broad-spectrum antiparasitic that became the cornerstone of one of the most successful public health programs of the past century. It’s also one of the most successful veterinarian medications widely used on dogs and horses.

It’s a systemic agent that acts against parasitic worms including strongyloidiasis, ascariasis, trichuriasis, filariasis, river blindness worms and enterobiasis, epidermal parasitic skin diseases, including scabies and head lice.

Ivermectin acts by inhibiting neurotransmission and by stimulating the release of gamma-aminobutyric acid-dependent neurotransmission. This causes paralysis of the somatic muscles and consequently the pharyngeal pump, resulting in the death of the parasite.

Although Ivermectin has been shown to be superior to albendazole it is used by many in conjunction with albendazole. Used by itself, Ivermectin is becoming the drug of choice in many countries due to its more favorable side effects compared with albendazole.

Against Strongyloides, it seems Ivermectin is combined with Fenbendazole in difficult disseminated cases. I started with Fenben instead of ivermectin because of Fenben’s very broad spectrum nature (it’s also antifungal). Now I’m guessing that was a mistake because I reacted so strongly to Fenben, it gives me intense migraines when it’s killing fungal slime.

So that scared me and made me think that ivermectin would be even more difficult. Now I see that Ivermectin doesn’t have any antifungal activity and I’m relieved. Maybe it’s narrower targeting will make it easier than Fenben.

One Curezone user (sharkman) who fought disseminated strongyloides successfully with the help of his veterinarian mom, has written extensively about his  long battle and wrote this:

My mom had me split my ivermectin into 2 half doses per day , which seemed to help in my treatment with less side effects . In all I been thru ivermectin was my best med in the beginning with treatment, wasn’t a fan of albendazole and I haven’t used anymore since November 2014.

Disseminated Strongyloides is often fatal so, this is a guy to pay attention to I think.

From the curezone protocol page (who knows why instructions say take it on an empty stomach when bioavailability is increased 2.5-fold when administered following a high-fat meal):

Ivermectin (Stromectol):  1 dose*, based on .2mg/kg, 1 hr before bedtime, on empty stomach, with 8oz water or beverage.  Take dose for 4 days on, 3 days off.  Repeat dosage every week (even during off-days of Albendazole) for 5 or more weeks, as needed, to cure infection.

Alternate Dosage Schedule:  For severe hyperinfection cases, follow this schedule instead of the above:  Take dose for 7 days on, 2 days off, 2 days on.  Continue the “pulse method” of 2 days off, 2 days on, etc, even during off-days of Albendazole, until infection is cured.

Post-Treatment for Strongyloides, Filariasis, & Morgellons:   Take a maintenance dose of Ivermectin every 7 days (once a week).  This suppressive therapy keeps any remaining encysted parasites sterile & prevents reinfection.

Ivermectin Side Effects:  When there is a heavy parasite burden, the first dose of Ivermectin might cause shortness of breath or abdominal discomfort.  This is caused by parasitic die-off & the toxins they release.  If extreme, stop dosage for 1-2 days & then resume.  These effects subside with subsequent doses as the parasite burden decreases.  See info below on the Herxheimer reaction.

Ivermectin (Stromectol) comes in 3mg, 6mg, & 12mg tablets.

I’m going to take a few days off Fenben to regain some strength before starting Ivermectin…

From the data sheet:

Pronunciation

(eye ver MEK tin)

U.S. Brand Names

Stromectol®

Generic Available

No

Use

Treatment of the following infections: Strongyloidiasis of the intestinal tract due to the nematode parasite Strongyloides stercoralis. Onchocerciasis due to the nematode parasite Onchocerca volvulus. Ivermectin is only active against the immature form of Onchocerca volvulus, and the intestinal forms of Strongyloides stercoralis.

Use – Unlabeled/Investigational

Has been used for other parasitic infections including Ascaris lumbricoides, Bancroftian filariasis, Brugia malayi, scabies, Enterobius vermicularis, Mansonella ozzardi, Trichuris trichiura.

Pregnancy Implications

Safety and efficacy have not been established in pregnant women. The WHO considers use after the first trimester as “probably acceptable.”

Lactation

Enters breast milk/not recommended

Contraindications

Hypersensitivity to ivermectin or any component of the formulation

Warnings/Precautions

Data have shown that antihelmintic drugs like ivermectin may cause cutaneous and/or systemic reactions (Mazzoti reaction) of varying severity including ophthalmological reactions in patients with onchocerciasis. These reactions are probably due to allergic and inflammatory responses to the death of microfilariae. Patients with hyper-reactive onchodermatitis may be more likely than others to experience severe adverse reactions, especially edema and aggravation of the onchodermatitis. Repeated treatment may be required in immunocompromised patients (eg, HIV); control of extraintestinal strongyloidiasis may necessitate suppressive (once monthly) therapy. Pretreatment assessment for Loa loa infection is recommended in any patient with significant exposure to endemic areas (West and Central Africa); serious and/or fatal encephalopathy has been reported during treatment in patients with loiasis. Safety and efficacy in children <15 kg have not be established.

Adverse Reactions

Frequency not defined.

  • Cardiovascular: Hypotension, mild ECG changes, orthostasis, peripheral and facial edema, transient tachycardia
  • Central nervous system: Dizziness, headache, hyperthermia, insomnia, somnolence, vertigo
  • Dermatologic: Pruritus, rash, urticaria, toxic epidermal necrolysis, Stevens-Johnson syndrome
  • Gastrointestinal: Abdominal pain, anorexia, constipation, diarrhea, nausea, vomiting
  • Hematologic: Anemia, eosinophilia, leukopenia
  • Hepatic: ALT/AST increased
  • Neuromuscular & skeletal: Limbitis, myalgia, tremor, weakness
  • Ocular: Blurred vision, mild conjunctivitis, punctate opacity
  • Respiratory: Asthma exacerbation
  • Mazzotti reaction (with onchocerciasis): Arthralgia, edema, fever, lymphadenopathy, ocular damage, pruritus, rash, synovitis

Overdosage/Toxicology

Accidental intoxication with, or significant exposure to unknown quantities of veterinary formulations of ivermectin in humans, either by ingestion, inhalation, injection, or exposure to body surfaces, has resulted in the following adverse effects: rash, edema, headache, dizziness, asthenia, nausea, vomiting, and diarrhea; other adverse effects that have been reported include seizure and ataxia

Treatment is supportive; usual methods for decontamination are recommended

Drug Interactions

Substrate of CYP3A4 (minor)

Ethanol/Nutrition/Herb Interactions

Food: Bioavailability is increased 2.5-fold when administered following a high-fat meal.

Mechanism of Action

Ivermectin is a semisynthetic antihelminthic agent; it binds selectively and with strong affinity to glutamate-gated chloride ion channels which occur in invertebrate nerve and muscle cells. This leads to increased permeability of cell membranes to chloride ions then hyperpolarization of the nerve or muscle cell, and death of the parasite.

Pharmacodynamics/Kinetics

Onset of action: Peak effect: 3-6 months

Absorption: Well absorbed

Distribution: Does not cross blood-brain barrier

Half-life elimination: 16-35 hours

Metabolism: Hepatic (>97%)

Excretion: Urine (<1%); feces

Dosage

Oral: Children

15 kg and Adults:

Strongyloidiasis: 200 mcg/kg as a single dose; follow-up stool examinations

Onchocerciasis: 150 mcg/kg as a single dose; retreatment may be required every 3-12 months until the adult worms die

Administration

Administer on an empty stomach with water.

Monitoring Parameters

Skin and eye microfilarial counts, periodic ophthalmologic exams

Dietary Considerations

Take on an empty stomach with water.

Patient Education

Medication should be taken with water. If infected with strongyloidiasis, repeated stool examinations are required to document clearance of the organisms. Repeated follow-up and retreatment is usually required in the treatment of onchocerciasis.

Dental Health: Effects on Dental Treatment

No significant effects or complications reported

Dental Health: Vasoconstrictor/Local Anesthetic Precautions

No information available to require special precautions

Mental Health: Effects on Mental Status

May cause dizziness, drowsiness, or insomnia

Mental Health: Effects on Psychiatric Treatment

May cause leukopenia; use caution with clozapine and carbamazepine

Dosage Forms

Tablet [scored]: 3 mg

References

de Silva N, Guyatt H, and Bundy D, “Anthelmintics. A Comparative Review of Their Clinical Pharmacology,”Drugs, 1997, 53(5):769-88.

“Drugs for Parasitic Infections,”Med Lett Drugs Ther, 1993, 35(911):111-22.

Ottesen EA and Campbell WC, “Ivermectin in Human Medicine,”J Antimicrob Chemother, 1994, 34(2):195-203.

International Brand Names

Baymec® (AU); Bimectin® (SE); Dairymec® (AU); Ecomectin® (AU); Equell® (DE); Equimec® (AU); Eqvalan® (BE, CH, FR, IE, NZ); Eraquall® (AT); Eraquell® (AU, CH, SE); Flurexel® (DE); Furexel® (BE, FR, GB, IE); Genesis® (AU); Heartgard® (AU); Heart Gold Chewable® (AU); Ivomec® (AT, AU, BE, CH, DE, GB, IE, NO, NZ, SE); Ivomec-P® (AT, DE); Ivomec Pour on® (AT, DE, GB, IE, NO, NZ, SE); Ivomec Premix® (DE, GB, IE, NZ); Ivomec S® (DE); Ivomec SR® (GB, IE, NO, NZ, SE); Mectizan® (EG, FR, ZA); Noromectin® (AU, GB, SE); Numectin® (AU); Optimectin® (CH); Oramec® (BE, FR, GB, IE); Panomec® (GB, IE); Paramax® (AU); Popantel Heartworm Tablets for Dogs® (AU); Revectina® (BR); Rycomec® (GB); Securo® (AR); Stockman® (NZ); Stromectol® (AU, FR); Totectin® (AU); Virbamax® (AU); Virbamec® (CH, DE, GB, SE); Virbamec S® (DE)

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  • avatar

    Sylvia July 17, 2016, 8:16 pm

    Hello Eric,
    Did this help? If so how do you know? And how did you get access to the vet meds?
    Was this more or less effective than “liver Flushes”? What is your favorite liver flush protocol.
    I was in India for 6 weeks as a teenager and have never quite recovered to full vibrancy. Although have treated myself with homeopathic protocols and a miserable goat milk flush. This was 20plus years ago.
    P.S. My hair mineral tests are profoundly toxic , including high cadmium, lead, nickel and mercury… ahh the life of the minimally energetic.

    • avatar

      Eric July 17, 2016, 10:51 pm

      It’s hard to say – I believe it was helpful but not a miracle worker for me. Until I lower my metal burden everything else is just going to be simply helpful and one more step on my path. I’m feeling very optimistic right now. Impossible to compare this with liver flushing. If you have 10 boxes to check, you can’t really substitute one for the other, you have to get them all.

  • avatar

    Tim Gray March 17, 2016, 11:47 am

    Hi Eric, I see you mention encysted parasites and was wondering if you could help. I’ve had pale stools (bright yellow) for a few weeks. It seems to coinside with chelation (DMPS 10mg & ALA 12.5mg) although after round it didn’t improve. It felt like my liver / gb / pancreas got blocked and I crashed. I had a Epsom Salt flush (like a liver flush but without the oil) which helped things. My gastro guy didn’t know what was going on (surprise surprise). The epsom salts helped and bile flow improved and my crash lifted. I started Milk Thistle and Desicated Liver which also helped – but in the meantime I got a CT of my liver/pancreas/GB and it showed a ‘simple cyst’. I do have a pain that comes and goes from my liver area.
    I’ve already got fenben but didnt start as I had my crash, but the cyst makes me think I might have a parasite. Do you think they fenben would help?

    – as a side note, I’ve had to stop methylation and iodine protocol as I needed to figure out what was causing what.

    I thought I’d just check and see what you think, as no one else seems to have researched or documented the things that I suspect

    Best Regards

    Tim

    • avatar

      Eric April 1, 2016, 4:35 pm

      Tim, I think this is above my head… have you thought about doing a series of liver flushes with oil?

    • avatar

      Audrey April 19, 2016, 12:41 am

      It most definitely could be a parasite. Possible liver and gallbladder flukes. Look into humaworm.com for a natural approach without the risky side affects.

"...nothing ever goes away
until it has taught us
what we need to know.
"
-Pema Chodron

"God, whose law it is that all who learn must suffer. And even in our sleep pain that cannot forget, falls drop by drop upon the heart, and in our own despair, against our will, comes wisdom to us by the awful grace of God."
-Aeschylus

About


My name is Eric - I‘m 48 and saw a doctor for fatigue at 17. I lived fairly normally if a little subdued by lack of endurance at times. But then, 12 years ago I fell into a nosedive after moving to South Florida. Now, I know heavy metal toxicity is a significant source of my troubles along with genetic methylation cycle dysfunction and Lyme disease. I spent 18 months chelating the metals out and starting up methylation but stopped when I felt myself circling the drain. Currently going after Lyme and co-infections. More about me here.

* supplements
* hair test
* genetics
* lessons learned

"Battles are won in their darkest hours. Wars are won by learning something from each battle."
-Eric

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